Comparing characteristics and outcomes of in-hospital cardiac arrest during the early and late COVID-19 pandemic at an academic institution in Saudi Arabia.

BACKGROUND: The COVID-19 pandemic has introduced major changes in the resuscitation practices of cardiac arrest victims. AIM: We aimed to compare the characteristics and outcomes of patients who sustained in-hospital cardiac arrest (IHCA) during the early COVID-19 pandemic period (2020) with those during the late COVID-19 pandemic period (2021). METHODS: This was a retrospective review of adult patients sustaining IHCA at a single academic centre. We compared characteristics and outcomes of IHCA for 5 months in 2020 with those experiencing IHCA for 5 months in 2021. RESULTS: Patients sustaining IHCA during the early COVID-19 pandemic period had higher rates of delayed epinephrine administration of more than 5 min (13.4% vs. 1.9%; p < 0.01), more frequent delays in the initiation of chest compressions (55.6% vs. 17.9%; p < 0.01), and were intubated less often (23.0% vs. 59.3%; p < 0.01). In terms of outcomes, both return of spontaneous circulation (35.8% vs. 51.2%; p < 0.01) and survival to hospital discharge rates (13.9% vs. 30.2%; p < 0.01) were lower during the early COVID-19 pandemic period. CONCLUSIONS: The early COVID-19 pandemic period was associated with delays in epinephrine administration and chest compression initiation for IHCA. Moreover, both return of spontaneous circulation and survival to hospital discharge were lower during the early COVID-19 pandemic period.

Use of antiepileptic medications for seizures' prevention during subarachnoid hemorrhage: A retrospective observational study.

The use of prophylactic antiepileptic drugs (AEDs) post-subarachnoid hemorrhage (SAH), particularly aneurysmal SAH, is controversial, with limited data available. This has led the new American Heart Association/American Stroke Association (AHA/ASA) guidelines to recommend against using AEDs. This study is aimed at determining whether the use of AEDs for primary prophylaxis is effective in reducing the incidence of seizures post-SAH. A retrospective observational study was conducted utilizing a reviewing chart for the period starting from June 2015 to the end of 2021. The reviews were conducted in the acute care areas of 2 tertiary hospitals primarily to assess the efficacy of AEDs against seizures in patients with SAH (particularly aneurysmal SAH). This was done by comparing the occurrence of early, late, and overall incidence of seizures between patients who received AEDs versus those who did not. Of the 62 patients, who mostly presented with aneurysmal SAH (71%), 42 received AEDs and 20 did not. Mostly, the baseline characteristics between the 2 groups were comparable. A few patients on AEDs developed early (n = 4/38), late (n = 3/29), and overall seizures (n = 6/33), whereas no early, late, or overall incidence of seizures was presented in the group who did not receive AEDs. However, this difference showed no significance (P > .05). The subjects who were given AEDs showed significantly longer hospital stays (42.11 ±â€…51.43 vs 14.10 ±â€…7.17; P = .002) and higher mortality rates (7/11 vs 0/11; P = .026). For all patients who received AEDs for prophylaxis, the overall incidence of seizures was negatively associated with the Glasgow coma scale (OR: 0.798; 95% CI 0.657-0.978; P = .022). Our findings support the 2023 AHA/ASA guideline recommendation to avoid using routine AEDs for prophylaxis for all SAH patients. Proper and careful stratification methods should be implemented in each given scenario.

Assessment of the Micro-Tensile Bond Strength of a Novel Bioactive Dental Restorative Material (Surefil One).

OBJECTIVES: The aim of this study is to assess the micro-tensile bond strength and the mode of failure of a bioactive hybrid self-adhesive composite (Surefil one) under various dentin conditions. METHODS: Thirty-two extracted human molar teeth were used to test the micro-tensile bond strength of Surefil one under different dentine conditions (no treatment, 37% phosphoric acid etching, and universal adhesive) in comparison with a resin-modified glass ionomer (RIVA). All restorations were light cure-bonded onto flat dentine and then sectioned into beams. Then, fractured specimens were observed under a light microscope to evaluate the mode of failure. RESULTS: The Surefil one no-treatment group (NTG) exhibited the highest micro-tensile bond strength. Furthermore, there was no statistically significant difference observed between the Surefil one adhesive group (EAG) and the Surefil one acid etch group (EG). However, compared to other groups, the resin-modified glass ionomer (RIVA) produced the lowest results, which are statistically significant. CONCLUSION: Surefil one offers superior bond strength values when compared to resin-modified glass ionomers. Furthermore, Surefil one requires no dentin condition and has more straightforward clinical steps.

Evaluation of the Relationship Between Smartphone Addiction and Lower Back Pain and Neck Pain Among Medical Students at Al-Baha University.

Introduction In recent years, the increased use of smartphones has adversely affected students, leading to issues like musculoskeletal pain. Therefore, our objective was to assess the correlation between smartphone addiction and neck and lower back pain. Methodology An observational cross-sectional study was conducted at Al-Baha University, Al-Baha, Saudi Arabia. The Smartphone Addiction Scale Short Version (SAS-SV) was used to measure the level of smartphone addiction while the Nordic Musculoskeletal Questionnaire (NMQ) was utilized to evaluate musculoskeletal pain. Results Smartphone addiction was prevalent in 72% of the participants (n = 293). Significantly, lower back pain was associated with smartphone addiction (p-value = 0.004). However, none of the demographic characteristics were associated with neck or lower back pain (p-value > 0.05). Students in clinical years had a higher risk of neck pain than those in an internship (p-value = 0.048). Conclusion Almost two-thirds of the students were addicted to smartphones, with a significant association with lower back pain. Students addicted to their smartphones had a higher risk of developing lower back pain, while clinical-year students had a higher risk of developing neck pain. It's important to raise awareness about the health and safety dangers linked to smartphones and other devices.

Comparing the Outcomes of Scalpel and Diathermocoagulation Dissection in Abdominoplasty: A Systematic Review and Meta-Analysis.

BACKGROUND: Abdominoplasty, an emerging surgical procedure worldwide, associated with complications, as seroma, infection, and hematoma. This systematic review and meta-analysis compare the outcomes of abdominoplasty procedures performed using a scalpel versus a diathermocoagulation device (diathermy monopolar electrocautery), aiming to find a safer approach with fewer complications. METHODS: We conducted a systematic search in November 2023 using PubMed, Ovid Medline, and Ovid Chocrane databases. The methodological index for nonrandomized studies and the Revised Cochrane Risk of Bias assessment tools were used to assess risk of bias for observational studies and randomized controlled trials, respectively. The data were analyzed using RevMan software. RESULTS: Six articles (1135 patients) were included, 521 patients were operated using a scalpel and 614 using electrocautery. Our analysis suggests that both seroma and drain output were seen more among the electrocautery group, with an odds ratio (OR) of 0.62 (95% CI [0.39, 0.97], p = 0.04) and - 103.63 (95% CI [- 205.67, - 1.59], p = 0.05), respectively. It is important to note the high heterogeneity seen among the studies discussing the total drain output. Additionally, we did not find any statistical significance between both techniques in terms of the rate of hematoma, wound infection, operation time, and hospital stay length. CONCLUSION: When comparing the use of scalpel and electrocautery dissection in abdominoplasty, higher rates of seroma and total drain output are significantly associated with electrocautery dissection. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The Prevalence and Predictors of Atherosclerotic Coronary Artery Disease in Rheumatic and Non-rheumatic Valvular Heart Disease Patients.

OBJECTIVES: The paradox of concurrent coronary artery disease (CAD) among patients with rheumatic and non-rheumatic valvular heart disease (RVHD; non-RVHD) is unclear. We aimed to evaluate the impact of the RVHD and non-RVHD on the prevalence of CAD and various risk factors, assess the number of diseased coronaries, clinical profile and the possible predictors of CAD in these patients, which may clarify the paradox and provide an insight for the prevention of CAD. METHODS: The records of 106 valvular heart disease patients who had undergone valve replacement surgery at the King Faisal Cardiac Centre from January 2014 to October 2019 were evaluated. The clinical data and established risk factors were compared and logistic regression analyses were performed to identify plausible predictors of CAD. RESULTS: Transthoracic echocardiographic diagnosis of 106 patients confirmed, 43 had RVHD (56.4 ± 8 years), of whom six (13.9%) had CAD with the highest mitral valve regurgitation (p < 0.01), and 63 had non-RVHD (60.0 ± 12 years). Of these, 31 patients showed the highest CAD (49.2%). Single- and triple-vessel disease was most common in RVHD and non-RVHD patients with concurrent CAD (33.3%; 41.9%, respectively), while non-RVHD patients also had quadruple vessel disease. The mean age of the RVHD and non-RVHD patients with coexisting CAD was significantly higher (66.7 ± 5; 66.7 ± 8 years) than those without CAD (46.1 ± 12.0; 54.7 ± 20, respectively). RVHD patients showed a significantly lower prevalence of diabetes, dyslipidaemia, hypertension, inflammatory cells, hepatorenal function markers, ejection fraction, and regional wall motion abnormality compared to RVHD patients with coexisting CAD (p < 0.01). Bivariate analysis indicated white blood cells, monocytes, neutrophils, gamma-glutamyl-transferase (GGT), bilirubin and blood urea nitrogen (BUN) to be significantly lower in RVHD patients. Predictors of high risk of CAD were BUN and hyperlipidaemia for RVHD and BUN, creatinine and GGT for non-RVHD patients. CONCLUSIONS: The prevalence of CAD in Saudi RVHD patients was significantly lower than in the Western countries, whereas non-RVHD was higher. The low prevalence may partly be attributed to age, reduced mitral regurgitation, and low frequency of risk and inflammatory factors.

The Efficacy of Fat Grafting on Treating Post-Mastectomy Pain with and without Breast Reconstruction: A Systematic Review and Meta-Analysis.

Post-mastectomy pain syndrome (PMPS), characterized by persistent pain lasting at least three months following mastectomy, affects 20-50% of breast surgery patients, lacking effective treatment options. A review was conducted utilizing EMBASE, MEDLINE, and all evidence-based medicine reviews to evaluate the effect of fat grafting as a treatment option for PMPS from database inception to 29 April 2023 (PROSPERO ID: CRD42023422627). Nine studies and 812 patients in total were included in the review. The overall mean change in visual analog scale (VAS) was -3.6 in 285 patients following fat grafting and 0.5 in 147 control group patients. There was a significant reduction in VAS from baseline in the fat grafting group compared to the control group, n = 395, mean difference = -2.17 (95% CI, -2.95 to -1.39). This significant improvement was also noted in patients who underwent mastectomy without reconstruction. Common complications related to fat grafting include capsular contracture, seroma, hematoma, and infection. Surgeons should consider fat grafting as a treatment option for PMPS. However, future research is needed to substantiate this evidence and to identify timing, volume of fat grafting, and which patient cohort will benefit the most.

Computational Optimization of Sandwich Silicone Rubber Composite for Improved Thermal Conductivity and Electrical Insulation.

The efficient dissipation of heat has emerged as a crucial concern for modern electronic devices, given the continuous increase in their power density and consumption. Thus, the utilization of thermally conductive but electrically insulating silicone rubber composites as a thermal interface material has garnered significant interest. In this study, the effects of the filler volume fraction, filler orientation, layer volume fractions, layer configuration, and a number of layers on the thermal conductivity and electrical resistivity of silicone rubber composites were examined using a multiscale finite element modeling strategy. The results demonstrated that modification of the filler orientation can change the thermal conductivity by 28 and 21 times in the in-plane and through-thickness directions, respectively. The in-plane thermal conductivities of silicone rubber/boron nitride and silicone rubber/expanded graphite layers exhibit a percolation phenomenon at filler volume fractions of 35% and 30%, respectively. The electrical resistivity of the composite increases exponentially with a decrease in the number of layers.

Epidemiology and clinical characteristics of Morganella morganii infections: A multicenter retrospective study.

BACKGROUND: Morganella morganii is a Gram-negative, opportunistic pathogen that can cause a variety of infections, including bloodstream infections, especially in those with compromised immune systems. It is often resistant to antibiotics, making it a difficult organism to treat. Limited studies have addressed M. morganii, but the organism is becoming increasingly recognized as a public health threat. More research is needed to understand the epidemiology and virulence factors of M. morganii in Saudi Arabia, as well as to develop effective treatment strategies. METHODS: This retrospective study included all M. morganii bloodstream infections patients admitted to five tertiary care hospitals in Saudi Arabia between 2015 and 2022. RESULTS: The study population included 75 patients (45 males and 30 females) between the age of 53-72 with a 54% ICU admission rate. The most comorbidities were hypertension followed by diabetes. The most common symptoms were fever, cough, shortness of breath, vomiting, and fatigue. The study also found that M. morganii was often resistant to multiple antibiotics, including ciprofloxacin, trimethoprim/sulfamethoxazole, gentamicin, amoxicillin, nitrofurantoin, and colistin. The most common treatment for M. morganii bacteremia was carbapenems, followed by aminoglycosides, ciprofloxacin, and colistin. Source control measures, such as surgery, line removal, drainage, and tissue removal, were also used in some cases. The study found that the in-hospital mortality rate for M. morganii bacteremia was 41%. The risk of mortality was increased in patients who were admitted to the ICU, who were older than 65 years, and who had Klebsiella pneumoniae co-infection. CONCLUSION: M. morganii bacteremia is a serious infection that is often resistant to antibiotics. Elderly patients and patients with comorbidities are at increased risk of mortality. Source control measures and appropriate antibiotic therapy are important for improving outcomes.

Physical activity levels among undergraduate students at the College of Applied Medical Sciences, King Saud University, Riyadh: A prevalence study.

Physical inactivity and sedentary behavior pose significant health concerns, particularly among young adults like college students. However, little research exists on the attitudes towards physical activity among Saudi Arabian healthcare students. This study aimed to assess the prevalence of physical activity and determine the reason for being physically inactive among students and interns across all programs in the College of Applied Medical Sciences (CAMS) at King Saud University (KSU), Riyadh, Saudi Arabia. A cross-sectional online survey was conducted between March and May 2023. CAMS students aged 18 and above, fluent in Arabic or English, and willing to participate were included. The Global Physical Activity Questionnaire (GPAQ) was used to measure physical activity. Descriptive statistics were used for data analysis. Out of 433 respondents, 377 met the inclusion criteria (response rate: 89.3%). Physical activity prevalence was 54.60%, with walking being the most common activity (42.70%). Lack of time was the primary reason for inactivity (51.40%). On average, students engaged in 1.5 hours/day of vigorous-intensity activities and 1.3 hours/day of vigorous-intensity sports and fitness activities at work. Sedentary behavior, characterized by continuous sitting, averaged 5.37 hours per day. Approximately half of CAMS students are physically active, while 20% rely solely on short walks due to time constraints, limited activity hours, or sedentary habits. A lack of time was cited as the primary reason for inactivity by most students. Future research should focus on strategies to enhance physical activity among healthcare students. In addition, academicians and policymakers should propose time-efficient initiatives that accommodate the demanding and busy schedules of healthcare students.

Awareness of Preeclampsia and Its Associated Factors Among Women in Al Baha Region, Saudi Arabia.

BACKGROUND: Preeclampsia is associated with the incidence of common fetal problems including intra-uterine growth restriction (IUGR), premature delivery oligohydramnios, placental abruption, fetal discomfort, and intrauterine fetal death. Pregnant women are not well-informed about preeclampsia, including its symptoms, risk factors, and consequences. The aim of the current study is to evaluate the awareness of preeclampsia and its associated factors among women in the Al Baha region, Saudi Arabia. METHODOLOGY: An observational cross-sectional design was employed to assess the awareness of preeclampsia and its associated factors among women in the Al Baha region of Saudi Arabia. Data was collected from April 2023 to September 2023. A questionnaire was designed to gather information on participants' sociodemographic characteristics (such as age, educational level, and residency) and their awareness of preeclampsia, including knowledge about signs/symptoms, risk factors, and complications. RESULTS: In the current study, we included 485 pregnant women. The majority of participants were aged 40 years or older (37.5%), followed by those aged 35-39 (20.4%). Among the participants, 70.9% confirmed that they had heard about pre-eclampsia before. The most common signs and symptoms were high blood pressure (47.4%), increased protein in urine (40.2%), continuous headache (39.2%), and vomiting/nausea (40.0%). Participants demonstrated awareness of obesity (29.7%), diabetes mellitus (35.5%), chronic hypertension (47.0%), and chronic kidney disease (31.3%) as major risk factors. Participants were aware of potential risks such as kidney disorders (34.6%), heart disorders (23.7%), and preterm delivery (50.9%). The analysis reveals that younger participants below 20 years old (3.3%) and lower educational levels (5.6%) had lower awareness of preeclampsia compared to older age groups. CONCLUSION: The findings of this study highlight a reasonable level of preeclampsia awareness and knowledge among Saudi Arabian women residing in the Al Baha region. While the majority of participants were familiar with preeclampsia, there were significant knowledge gaps regarding the precise symptoms, risk factors, and consequences of the condition.

Do-not-resuscitate (DNR) Orders' Awareness and Perception Among Physicians: a National Survey.

Background: The concept of do-not-resuscitate (DNR) orders began when medical and surgical interventions increased the possibility of resuscitation in dying patients. Healthcare providers should start to care more about the quality of life rather than quantity. The acceptance of signing DNR orders varies among physicians owing to different reasons and conceptions. Objective: The aim of this national survey was to evaluate the extent of physicians' knowledge and attitude towards do-not-resuscitate (DNR) orders in different hospitals and specialties in Saudi Arabia. Methods: A cross-sectional study was conducted in Saudi Arabia and other Arab Gulf countries between March 2019 and May 2021. Results: A total of 409 physicians completed the questionnaire (53.3% male, 47% of the participants were less than 30 years of age). Most participants had their residency medical training in Saudi Arabia (73.6%, n=281); 33.5% were emergency medicine (EM) physicians. Among 409 patients, 92.7% (n=379 ) were familiar with the DNR (do-not-resuscitate) ter. Half of the participants had never discussed a DNR status with the patient or family (n=215, 52.6%), however, only 38.4% had read the policy. A total of 275 (67.2%) participants were aware that their institute had a DNR policy, and a lack of patient/family understanding was the most common barrier for the majority to initiate DNR orders (53.9%, n=222). Most of the participants (65.8%, n=269) acknowledged a lack of training and understanding of the concepts of DNR orders. Conclusion: Most physicians who participated in this study were aware of the DNR order concept; however, half of them had never discussed or signed a DNR order. Patients and their families' misunderstandings were considered the main barriers. In addition, the lack of training in the concepts of DNR orders was considered a major obstacle.

Evaluation of Osteoporosis Perception Among Saudi Arabian Premenopausal Women: A Cross-Sectional Survey Study Using the Osteoporosis Knowledge Assessment Tool (OKAT).

INTRODUCTION: Osteoporosis is a major clinical problem that affects the whole population, especially women. It is a condition that is becoming more prevalent with aging. The increase in bone fragility associated with the disease can lead to fractures, even from minor trauma. Our goal is to evaluate the extent of knowledge about osteoporosis and perceptions of it among premenopausal women in Saudi Arabia. METHOD: This descriptive cross-sectional study was conducted among premenopausal women during the months of June and July 2021. We distributed an online questionnaire on social networking sites and applications that Saudi women use on a daily basis. We used the Osteoporosis Knowledge Assessment Tool (OKAT) to evaluate the responses. RESULT: A total of 661 women took part in our study; 159 of them were excluded because they had either reached the menopausal period or had already been diagnosed with the disease. The overall perception of osteoporosis is noticeably poor, as only 55% of respondents had an acceptable level of knowledge. In addition, we found a statistically significant association between education level and knowledge level (p-value = 0.044). CONCLUSION: The findings revealed that more than half the participants scored "acceptable" in terms of their understanding of the disease, which indicates a serious awareness gap. This outcome demonstrates the necessity of increasing community awareness about osteoporosis to reduce potential harm and the financial burden of healthcare.

Assessment of Sleep Quality Among Adolescents and Adults With Self-Diagnosed Irritable Bowel Syndrome, in Jeddah, Saudi Arabia.

Background The frequency of irritable bowel syndrome (IBS) has increased significantly in the last ten years. Few studies were done in Saudi Arabia to assess the relationship between sleep quality and IBS. This study aims to assess the prevalence of IBS and its association with sleep quality among adolescents and adults in Saudi Arabia. Methods A cross-sectional study was done on 651 participants aged 15-65 years. An online questionnaire was used to collect data, including demographics; the Rome IV criteria (R4DQ) was used in the diagnosis of IBS, the IBS symptoms severity scale (IBS-SSS) assessed IBS symptoms and severity, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results Based on the Rome IV criteria, 25.7% of the participants had IBS. Among them, 23.3%, 17.9%, 47.3%, and 11.5% had IBS types constipation (C), diarrhea (D), mixed bowel habits (M), and undefined subtype (U), respectively. Mild, moderate, and severe IBS were found among 43.1%, 39.5%, and 17.4% of IBS cases, respectively. About 46% had poor sleep quality, which was significantly higher among those with younger mean age, females, and students. Patients with IBS exhibited a considerably greater prevalence of poor sleep quality, and IBS-C had the highest prevalence. Conclusion A correlation was found between poor sleep quality and the positive status of IBS diagnosis among adolescents and adults. An evaluation of specific sleep disorders among IBS patients is needed.

Photo-induced photoacoustic streaming and pineapple peel extract as final irrigant on extrusion bond strength of root filling material to canal wall.

Objective: Photon-induced photoacoustic streaming (PIPS) with pineapple peel extract (PPE) and ethylenediaminetetraacetic acid (EDTA) as a final endodontic irrigant on the push-out bond strength (PBS) of root filling material to conventional irrigation NaOCl with EDTA. Methods: An in vitro study at Dar Al Uloom University was conducted over three months. Root canal preparation was performed. Based on final irrigation, all the specimens were divided randomly into four groups (n=10) Group 1: 2.25% NaOCl+ 17% EDTA (control), Group-2: 2.25% NaOCl+PIPS + 6.25% PPE, Group-3: 2.25% NaOCl+PIPS + 17% EDTA, Group-4: 2.25% NaOCl + 6.25% PPE. Canals were obturated and sealed with AH Plus sealer. Root sectioning was performed at 1mm thickness and PBS testing was performed using the universal testing machine. The debonded samples were analyzed for failure mode. ANOVA compared the means and standard deviations (SD) of all investigated group. Assessment of multiple comparisons was performed using Tukey's post hoc test. Results: The maximum PBS was demonstrated by the coronal section of Group-2 (2.25%NaOCl +PIPS+6.25%PPE) specimens (8.21±0.81MPa). The apical section of Group-1 (2.25% NaOCl+17% EDTA) specimens demonstrated minimum bond strength (2.80±0.18 MPa). The intergroup comparison revealed that Group-3 (2.25% NaOCl +PIPS +17% EDTA) and Group-2 demonstrated comparable outcomes (p>0.05). Group-4 (2.25% NaOCl +6.25% PPE) specimens established significantly lower values than Group-3 and Group-4 (p<0.05). Conclusion: Photon-induced photoacoustic streaming with pineapple peel extract and EDTA demonstrated better bond strength of root canal sealer and have the potential to be used as the final irrigant.

A novel intelligent agent-based framework for appropriate stream selection from perceptive of career counseling.

Picking a career stream profoundly influences people's abilities in different ways. Nowadays, choosing the correct career stream in advanced education is troublesome, as the number of people wanting to be in specific specializations is growing. Therefore, it is essential to be able to select the appropriate career path. This article proposes a system that can suggest streams in advanced education schools. This system is influenced by agent-based stream proposal systems (ASPS). The proposed system aims to make picking out the correct stream to study at school simpler for an individual. Different streams are evaluated based on seven pre-characterized models. In our system, three unique sorts of tests, learning styles, and coaching were coordinated in a way that caused the system to recognize an individual's interests and limits to an area of study. A sample of 238 participants was recruited for our questionnaire on accessibility, user-friendliness, accuracy, and satisfaction with the system. The incorporation of learning styles and coaching proved helpful in the study. The reliability and validity were proven in addition to incorporating a thinking-aloud protocol and immediate evaluation in the pre-, during and post-tests. To a large extent, respondents were satisfied with the model, as was revealed in the Likert scale response frequencies and percentages. The proposed system can be applied to undergraduates choosing engineering, medicine, arts and science degrees.

Studying the dimensions of m-interactivity and customers' engagement in m-commerce applications.

These days, technology has a significant role in the success of selling and buying goods through m-commerce applications. Therefore, this study aims to study the impact of dimensions of M-interactivity on customers' engagement in m-commerce and the effect of customers' attention in m-commerce on customer loyalty towards m-commerce applications. The questionnaire was distributed among Saudi citizens. The five hundred questionnaire links were distributed randomly among Saudi citizens. The partial least squares (PLS) were implemented to analyse the data to test the proposed hypotheses and get the rest of the results. The results revealed that the questionnaire used in this study was valid and reliable. Also, it revealed that active control, connectedness, responsiveness, and synchronicity positively impact customers' engagement in m-commerce applications. Furthermore, it showed that ubiquitous connectivity and personalization do not positively impact customers' attention in m-commerce. In addition, the results revealed that customer engagement positively impacts customer loyalty (LO) in m-commerce applications.

Impact of the COVID-19 Lockdown on Children's Psychosocial Well-Being: A Cross-Sectional Study in Saudi Arabia.

Background The impact of COVID-19 on children is a vital topic to cover since the quarantine lasted for months, and limited research explored this effect locally in Arab countries. We studied the impact of the COVID-19 lockdown on the psychosocial well-being of children aged 1-18 years who were living in Saudi Arabia during the time of the pandemic. Method A total of 387 participants' responses were collected using online questionnaires (valid and reliable) composed of three sections with open and close-ended questions by the child's legal guardians. This cross-sectional study was conducted in Saudi Arabia and targeted children aged 1-18 years of both genders using a convenience sampling technique. One questionnaire assessed the child's behavior and sleep pattern, while the other evaluated child's activity and social skills. We analyzed the data using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY). Results Half of the children were 1-6 years (196; 50.6%), and the caregivers of more than half (225; 58.2%) were mothers. Two-thirds (234; 60.5%) of the children were male. Apart from a poor appetite for food and eating (non-nutritional) junk food, which was not significant (p-value > 0.05), all other factors, behavior, sleep patterns, activity, and social skills, all other factors were significantly affected by COVID-19 (p<0.05). Conclusion This study found that the COVID-19 pandemic had a negative impact on children's psychosocial well-being. It is recommended to implement actions that aim to enhance the ability of children to cope with challenges.

Relationship Between Heart Disease and Obesity Indicators Among Adults: A Secondary Data Analysis.

Background Body mass index (BMI), waist circumference (WC), and hip circumference (HC) determine obesity. Several studies have examined the association between obesity and many diseases, including heart disease, and found it to be a substantial risk factor. However, the relationship between heart disease and obesity has not been investigated. This study investigated the relationship between heart disease and obesity indicators among adults encompassing sociodemographic and lifestyle factors. Methodology This cross-sectional study included data from 3,574 individuals who participated in the 2011-2014 National Survey of Midlife Development in the United States refresher. The presence or absence of heart conditions such as irregular heartbeat, heart murmur, heart attack, and heart failure was determined using self-reported questionnaires. The association between heart disease and obesity indicators such as BMI, WC, HC, and waist-to-hip ratio (WHR) was investigated using linear regression. Results After controlling for all factors, the findings demonstrated a significant relationship between heart disease and BMI, WC, and HC high scores of 1.12 kg/m2, 0.63 inches, and 0.81 inches, respectively. A higher score in all obesity indicators was linked to being 65 years or older; male gender (for HC); having a school/college level of education; being unmarried, divorced, or widowed; having a history of smoking; and avoiding alcohol use. Conclusions Heart disease and sociodemographic and lifestyle factors are substantially associated with a high score in all obesity indicators. The findings of this study are important because they can assist healthcare providers in implementing different therapies to prevent high BMI, WC, HC, and WHR.

Intelligent Transportation Using Wireless Sensor Networks Blockchain and License Plate Recognition.

License Plate Recognition (LPR) is essential for the Internet of Vehicles (IoV) since license plates are a necessary characteristic for distinguishing vehicles for traffic management. As the number of vehicles on the road continues to grow, managing and controlling traffic has become increasingly complex. Large cities in particular face significant challenges, including concerns around privacy and the consumption of resources. To address these issues, the development of automatic LPR technology within the IoV has emerged as a critical area of research. By detecting and recognizing license plates on roadways, LPR can significantly enhance management and control of the transportation system. However, implementing LPR within automated transportation systems requires careful consideration of privacy and trust issues, particularly in relation to the collection and use of sensitive data. This study recommends a blockchain-based approach for IoV privacy security that makes use of LPR. A system handles the registration of a user's license plate directly on the blockchain, avoiding the gateway. The database controller may crash as the number of vehicles in the system rises. This paper proposes a privacy protection system for the IoV using license plate recognition based on blockchain. When a license plate is captured by the LPR system, the captured image is sent to the gateway responsible for managing all communications. When the user requires the license plate, the registration is done by a system connected directly to the blockchain, without going through the gateway. Moreover, in the traditional IoV system, the central authority has full authority to manage the binding of vehicle identity and public key. As the number of vehicles increases in the system, it may cause the central server to crash. Key revocation is the process in which the blockchain system analyses the behaviour of vehicles to judge malicious users and revoke their public keys.